Provider Demographics
NPI:1447079017
Name:LOPEZ, YUKI (MAT)
Entity type:Individual
Prefix:
First Name:YUKI
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-1896 KOHANAHANA LOOP
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-7852
Mailing Address - Country:US
Mailing Address - Phone:808-476-5514
Mailing Address - Fax:
Practice Address - Street 1:458 MANAWAI ST APT 1203
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-4612
Practice Address - Country:US
Practice Address - Phone:808-367-0986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT-17893225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist